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Biocultural pathways linking periodontal disease expression to food insecurity, immune dysregulation, and nutrition
Author(s) -
Dent Sophia C.,
Berger Steph M.,
Griffin Jacob S.
Publication year - 2020
Publication title -
american journal of human biology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.559
H-Index - 81
eISSN - 1520-6300
pISSN - 1042-0533
DOI - 10.1002/ajhb.23549
Subject(s) - context (archaeology) , disease , immune dysregulation , immune system , immunology , micronutrient , medicine , national health and nutrition examination survey , periodontal disease , vitamin d and neurology , physiology , environmental health , biology , population , pathology , paleontology
Objectives In this article, we test theoretical pathways leading to and resulting from periodontal disease to better understand how periodontal disease, which is measurable in both past and present populations, integrates biocultural context and affects whole‐body physiology. Methods We use data from the National Health and Nutrition Examination Survey (NHANES) 2003‐2004 and logistic and linear regressions to test pathways linking psychosocial stress to periodontal disease, and periodontal disease to serum vitamin C levels. We then use causal mediation analysis to test the role of mediating variables in these pathways ( n = 1853 individuals). Results Food insecurity was positively associated with periodontal disease and negatively associated with serum counts of C‐reactive protein (CRP) and neutrophils. Neither CRP nor neutrophils significantly mediated the relationship between food insecurity and periodontal disease. Periodontal disease was negatively associated with serum vitamin C levels and positively associated with neutrophil counts. Neutrophils may mediate the relationship between periodontal disease and vitamin C. Conclusions We identify two main findings: (a) periodontal disease contributes to and may result from immune dysregulation, particularly of neutrophils, and (b) an immune response to chronic infection such as periodontal disease is metabolically expensive for the body to maintain and likely depletes serum micronutrient levels. Both micronutrient status and serum neutrophil counts affect multiple skeletal and physiological phenotypes and thus position periodontal disease in whole‐body context.